Report on Childhood Obesity in China (4) Prevalence and Trends of Overweight and Obesity in Chinese Urban School-age Children and Adolescents, 1985-2000

Objective To describe the nationwide prevalence of childhood overweight/obesity, and their group variations and trends over the past 20 years in the Chinese urban population. Methods Data sets of boys and girls at the age of 7-18 years collected from the series of Chinese national surveillance on students＇ constitution and health （CNSSCH） between 1985 and 2000 were divided into five socioeconomic and demographic groups, while BMI classification reference proposed by Working Group on Obesity in China （WGOC） was used as screening reference to calculate the prevalence and trends of overweight/obesity in these groups. Results In 2000, the prevalence of obesity and overweight in boys aged 7-18 years was 11.3% and 6.5% in Beijing, 13.2% and 4.9% in Shanghai, 9.9% and 4.5% in coastal big cities, and 5.8% and 2.0% in coastal medium/small-sized cities, respectively, while the prevalence of of obesity and overweight in girls of the same age group was 8.2% and 3.7% in Beijing, 7.3% and 2.6% in Shanghai, 5.9% and 2.8% in coastal big cities, and 4.8% and 1.7% in coastal medium/small-sized cities, respectively. The prevalence of obesity was low in most of the inland cities at an early stage of epidemic overweight. The epidemic manifested a gradient distribution in groups, which was closely related to status （SES） of the study population. However, a dramatic and steady increasing trend was witnessed among all sex-age subgroups in the five urban groups, and such a trend was stronger in boys than in girls, and much stronger in children than in adolescents. Conclusion Although China is at an early stage of epidemic obesity by and large, the prevalence of obesity in her urban population, particularly in coastal big cities has reached the average level of developed countries. The increasing trend has been rapid since early 1990s, and the increments in obesity and overweight are exceptionally high. The prospect of epidemic obesity in China is in no way optimistic. Therefore, preventive program should be focused on the improvement of the balance between caloric intake and energy expenditure, and interventions aimed at changing children＇s life styles.

Etiology of Diarrhea among Severely Malnourished Infants and Young Children: Observation of Urban-Rural Differences over One Decade in Bangladesh

There is inadequate information on the etiology of diarrhea in severely malnourished (SM) young children. Thus, the study aimed to determine the etiology of diarrhea among severely malnourished (z score ?3.00 SD) children in rural and urban Bangladesh. From the database (2000-2011) of Diarrheal Disease Surveillance Systems (DDSS) at rural Matlab and urban Dhaka hospitals of icddr,b, 2234 and 3109 under-5 children were found severely malnourished (underweight, stunted or wasted) respectively. Two comparison groups [moderately malnourished (MM) and well-nourished (WN)] were randomly selected in a ratio of 1:1:1. Children with all categories of SM were more likely to be infected with Vibrio cholerae (rural—11%;urban—15%), Shigella (16%;9%), Salmonella (1%;2%) and Campylobacter (3%;4%);and less likely to have rotavirus (25%;20%) compared to only one SM category. Isolation rate of Vibrio cholerae was significantly higher among SM both in rural and urban children (7%;13%) than those of MM (5%;10%) and WN (2%;8%) and lower for rotavirus (30%;31%), (34%;43%), (35%;47%) respectively (p 0.01). However, for Shigella it was only higher among rural SM children (11%) [MM (9%), and WN (8%) (p 0.01)]. The isolation rate of Salmonella in SM (2%) was similar to that in MM (2%;p = 0.72) but significantly higher than that in WN (1%;p 0.01) among urban children. Isolation rates of bacterial enteric pathogens were higher but rotavirus was lower in SM children in both rural and urban area with geographical heterogeneity.

Obesity, Body Fat Distribution, and Physical Activity in School-age Children: an Urban and Rural Comparison in Valparaíso, Chile

This study analyze the relation between body composition, physical activity （PA）, and sex in Chilean children from rural and urban public educational institutions. The prevalence of obesity （according to BMI） was 30.88% in urban children and 28.93% in rural children. Central obesity presented mainly in the rural girls. Approximately 90% of the participants reported 〈7 h of PA/week, regardless of residential area. In addition, central fat was strongly associated with rural residence; the children reported lower PA levels, and they presented a higher prevalence of central fat. The results reflect the need to implement programs to improve PA conditions in the child urban-rural population.

Nutritional Status of Under-five Children from Urban Low-income Families in Xiangtan and Jilin in China

There have been many studies on the nutrition and the growth status of children from rural and remote western regions of China, whereas researches on children from urban low-income families are scarce. This study aimed to investigate the growth and nutritional status of children under five years of age from urban low-income families in China. There were 169 children aged 25–60 months recruited from Xiangtan and Jilin, two cities with a population of 2.81 million and 4.26 million respectively, in China in this cluster cross-sectional study. Data were collected on demographic and socioeconomic characteristics, the feeding practices and the incidence of anemia and diarrhea. The results showed that the prevalence of low birth weight and macrosomia was 7.1% and 9.5% for the two cities, respectively, which was higher than that for other cities in China（1.5% and 5.9%）. Of all the sampled children, 14.6% and 8.2% suffered anemia and diarrhea, respectively. Multivariate analysis showed that legumes or nuts fed in a 24-h recall increased the risk of anemia（OR=4.9）. Children whose caregivers began to introduce complementary foods relatively late would have high diarrhea prevalence（OR=1.4）. In conclusion, the prevalence of anemia and diarrhea in under-five children from urban low-income families in China is relatively high. The growth and nutritional status of these children is greatly affected by feeding practices. A series of measures should be taken by relevant government departments to improve the health of these children.

Current Status and Predictors of Diarrhoeal Diseases among Under-Five Children in a Rapidly Growing Urban Setting: The Case of City Administration of Bahir Dar, Northwest Ethiopia

Background: Diarrhoeal disease in under-five children is a serious public health challenge especially in low income countries including Ethiopia. In Ethiopia, several interventions are going on to reduce morbidity, and mortality of children. The objective of the study was to assess the prevalence and associated factors of diarrhoeal diseases among under-five children in the City Administration of Bahir Dar. Methods: A community based cross-sectional study was conducted on a sample size of 667 mothers/caregivers having under-five children. Participants were selected through multistage sampling technique. Structured questionnaire and observation checklist were used to collect data. It was analyzed using SPSS version 16 for windows. Logistic regression was applied to measure possible associations. Strength of association, and statistical significance was measured using odds ratio and confidence interval at 95% confidence level. Results: A total of 667 mothers/ caregivers with under-five children were included in the study. Two-week prevalence of diarrhoea was 21.6%. Households in rural part of the city (OR: 2.82, 95%CI: 1.66 - 4.81), monthly income ≤ birr 500 (OR: 2.27, 95%CI: 1.44 - 3.57, failure to use separate container for storing drinking water (OR: 1.78, 95%CI: 1.17 - 2.70), presence of human excreta in the compound (OR: 1.88, 95% (1.15 - 3.06) were found to be predictors of childhood diarrhoea. Conclusion: Diarrhoeal diseases remain serious public health challenge in rural as well as urban set ups in Ethiopia with particular reference to Bahir Dar City, despite several interventions over decades. Therefore, interventions, and strategies applied so far to eliminate diseases of poverty including diarrhoeal diseases should be re-visited.

Trend of <i>Cryptosporidium</i>Infection among Children below 24 Months in an Informal Urban Settlement, Kenya

Cryptosporidium infection is estimated to cause 2.9 million diarrheal cases yearly among children aged under 24 months in sub-Saharan Africa. Studies have shown long-term climatic variations can affect infectious diseases. The burden of cryptosporidiosis in rural areas of sub-Saharan Africa is well characterized. However, the trend of Cryptosporidium infection is not known, especially in informal urban settings. This study therefore sought to determine cryptosporidiosis trends, and further explore the association between year and Cryptosporidium infection among children below 24 months in Kibera urban informal settlement in Kenya. Data collected by the Kenya Medical Research Institute longitudinal study in Tabitha clinic in Kibera from 2009 to 2015 were used. At least 3000 children aged < 24 months receive free health care at the clinic. In the longitudinal study, children presenting with diarrhea were eligible for stool sample collection (n = 477), out of which 421 stool samples were tested using TaqMan™ Array Card (TAC) polymerase chain reaction panel that included a target for Cryptosporidium genus. Data for the 421 children were included in the analysis. Logistic regression was used to explore the difference between the seven years and cryptosporidiosis. Overall, the pooled data indicated that 23.5% of the children who were tested had Cryptosporidium infection, with the highest proportions of Cryptosporidium-positive cases observed in 2015 (45.2%). The logistic regression results also indicated that children who were tested in the year 2015 were more likely to have Cryptosporidium infection (OR = 3.39;95% CI: 1.44 - 7.96;p = 0.005) than those in 2009. Watery stool was also found to be an important symptom of cryptosporidiosis. There was a high prevalence of Cryptosporidium infection among young children, especially in the most recent year. Routine testing of Cryptosporidium infection using molecular methods, constant monitoring and identification of the infection sources is therefore necessary towards reducing the disease burden in the low resource settings.

A comparative study on the extracurricularreading environment of urban and rural children in Chongqing Reservoir Area

Purpose: So far, there have been few studies that discussed children’s reading environment in China’s poverty-stricken areas, this study aims to explore differences existed in extracurricular reading environment between urban and rural children in Chongqing Reservoir Area with empirical evidence.Design/methodology/approach: Using a questionnaire survey, empirical data was collected from 105 participants. Then proposed hypotheses and the reliability of the observation variables were respectively examined with ANOVA and factor analysis. The statistical analysis software SPSS19.0 was used to analyze the data.Findings: Our results showed that 1) differences did exist in school and social reading environment between urban and rural children in Chongqing Reservoir Area; 2) differences in family reading environment between urban and rural children in Chongqing Reservoir Area were not obviously observed.Research limitations: The empirical data were collected from only one county of Chongqing Reservoir Area, which may have partially affected the generalization of our conclusions. In addition, the response rate of questionnaires was comparatively low due to a relatively limited research period. Practical implications: This study would provide some reference for governments, libraries, schools and families to consider how to jointly narrow the gap in the extracurricular reading circumstance between urban and rural children in Chongqing Reservoir Area.Originality value: This is one of the first studies to explore similarities and differences in extracurricular reading environment between urban and rural children in Chinese povertystricken areas, which will help research communities to gain a deeper understanding of children’s reading environment in Chinese Reservoir Area.

Childhood Obesity in Primary School Children of Middle and Upper-Middle Income Group in the Capital City of Bangladesh

Background: No published information is available on the status of childhood obesity in Bangladeshi primary school children of urban middle and upper-middle income group. The aim of the study was to explore the proportion of childhood obesity in the primary school children of middle and upper-middle income group in capital city and to gather information on their dietary pattern and physical activity. Methods: One hundred and fifty children (age 9 ± 1 years, height (ht) 118 ± 20 cm, weight (wt) 36 ± 8 kg, wt/ht% 126 ± 24, mean ± SD) were selected purposively from the primary schools of Dhaka city. On the basis of predefined scoring, subjects were classified as underweight, normal, overweight and obese if their weight-for-height values were 120% of median values for Bangladeshi children respectively. Dietary intake and energy expenditure of the study subjects were calculated by standard techniques. Results: The proportion of childhood overweight and obesity was 52% and 20%. The proportion of overweight and obesity was higher (78%) among girls compared to boys (54%). Similarly, height, weight and other anthropometrics indices were significantly (p < 0.05) higher in girls compared to boys. The daily intake of carbohydrate and protein was significantly (p < 0.05) higher among obese group. Total energy balance was significantly correlated with weight-for-height% (r = 0.541, p = 0.0001). Conclusions: A higher proportion of overweight and obesity had been found in girls’ children than their counter parts in this study. Positive energy balance with higher energy intake from carbohydrate and fast/processed food culture habit were found among primary school children of middle and upper-middle income group in the capital city of Bangladesh.

惠农义务教育政策执行中的“空转”现象与矫治——城镇化进程视野下的分析

作为推进城乡教育公平的关键,惠农义务教育政策已经实施多年,但城镇化的快速发展引致流动随迁子女和留守儿童现象并存。原有的惠农义务教育政策陷入了执行中的“空转”困境,具体表现在:一些施惠措施的目标精准性和时代适应性不足、城市学校义务教育资源难以均衡惠及流动人口、留守儿童义务教育质弱量缺的困局尚未扭转。基于政策执行过程分析框架,从政策执行的视角发现:公共服务消极供给、顶层设计不足、流入地财政压力过大、农民工参与空间与能力有限是造成惠农义务教育政策“空转”现象的主要原因。基于城镇化进程提出四个矫治路径,即:推进更高质量的城镇化、让农民有更多机会进入公共决策体系、建立完善的经费保障机制和消除社会歧视,以期提高惠农义务教育政策执行的有效性。

城市义务教育入学门槛与流动人口子女随迁决策——人口流动新形势下的教育资源空间配置优化

在流动人口向城市群集聚的新形势下,城市群承担着创新公共服务均等化提供机制的重要责任。以长三角城市群为样本,基于政策文本研究各城市针对流动人口随迁子女设置的义务教育入学门槛,并定量分析其对流动人口子女随迁决策的影响。研究发现,各城市以材料准入制和积分入学制两种模式设置入学门槛,其高低并没有呈现从核心城市(上海)到中心城市(南京、杭州等)再到其他城市递减的趋势。义务教育入学门槛与子女随迁之间具有显著的负相关关系,高入学门槛城市比低入学门槛城市的流动人口子女随迁几率低55%,且这种关系在低收入流动人口群体中更加明显。为了构建人口流动新形势下的共享型教育体系,应当优化教育资源的空间配置:在理念上探索城市群教育资源统筹配置的思路,在制度上创新突破行政区划的教育公共服务提供机制,在技术上完善以常住人口为基础的义务教育资源规划布局。

儿童友好视角下的城市公园儿童户外游戏空间功能性评价——以成都市为例

近年来,成都市坚持以儿童友好助推全龄友好,优化城市环境。城市公园作为城市环境的重要一环,其以儿童游戏空间为导向的功能性评价体系构建对推进儿童友好城市建设尤为重要。文章采用实地调研和感知地图法,基于文献研究与专家咨询意见,通过层次分析法-熵值法构建了城市公园儿童户外游戏空间功能性评价体系,并开展实证分析,最终基于评价结果对儿童户外游戏空间的功能性设计提出优化建议。

新生代农民工举家迁移对教育支出的影响研究

基于中国家庭追踪调查数据和实地调研发现:存在子女随迁现象的新生代农民工家庭均为举家迁移。举家迁移显著增加家庭教育支出,随迁子女数与家庭教育支出显著正相关。家中既有男孩又有女孩的举家迁移家庭教育支出显著增加,家中只有男孩的家庭教育支出显著高于家中只有女孩的家庭。相比中部和东部,西部新生代农民工举家迁移显著增加家庭教育支出。建议积极落实“两为主”“两纳入”“两统一”“同城化”等随迁子女教育政策,切实减轻农民工家庭教育负担;统筹义务教育资源均衡配置,努力缩小教育区域化差异;完善户籍制度和流动人口服务体系,衔接城乡有关社会保障与福利政策,促进农民工随迁家庭整体市民化。

新时代城市公共社会福利设施规划标准研究——走向全龄友好社会

国家“十四五”规划及2035远景目标纲要提出“增进民生福祉、提升共建共治共享水平”,对我国社会福利设施体系提出了新目标。既有的城市公共社会福利设施体系、设施功能、规划标准等已经无法满足新时代的社会发展需求。基于我国社会福利事业的发展情况,以面向老年人、儿童和残疾人的城市公共社会福利设施为重点研究对象,系统梳理了既有设施体系及存在的主要问题,根据相关设施规划标准在实践中的应用反馈,对新时代国家层面城市公共社会福利设施规划标准的修订提出了总体思路,并从体系完善、级配方式、指标修订、选址要求等方面提出了建议。

中国城乡幼儿体质健康状况研究进展

我国幼儿整体体质健康状况虽有所改善,但城乡区域差异仍然明显,主要体现在幼儿饮食营养、作息睡眠和体力活动3个方面。基于Bronfenbrenner的生态系统理论,本文从微观、中观和宏观视域,对我国城乡幼儿体质健康发展的影响因素及干预策略等相关研究进行了综述,以期为如何促进幼儿体质健康水平的提高,缩小城乡幼儿体质健康差异等方面的研究工作提供新的方向与思考。

论《皇帝的孩子》中的城市景观与知识分子体验

小说《皇帝的孩子》在书写美国纽约高知分子间纷繁复杂的人际关系,展现文化圈层虚伪与浮华的同时,多次指向城市中典型的非场所意象,表达了精英阶层城市生活的荒诞与体验的虚无。该群体的神秘色彩逐渐被都市光怪陆离的乱象消费殆尽,但其中不乏有觉醒个体在经历恐怖事件后,以游荡者身份反思自我处境并展开返魅之旅。作家意在借助9·11事件刺激知识分子沉思被城市景观包围下现代性生活弊病和精神危机,在游荡中寻找城市的缺口并主动参与景观重建。以核心人物布狄为线索,从城市化表征视角分析城市意象,作品考察了城市中受现代性宰制的知识分子精神陷落问题,深入探索其都市体验,为该形象赋予更深的社会意义。

流动儿童亲子沟通与同伴侵害亚类别的关系:基于潜在剖面分析

以北京市719名4~6年级流动儿童为被试,采用自陈式量表测查流动儿童的同伴侵害、亲子沟通和内外化问题。采用潜在剖面分析,探讨流动儿童同伴侵害的亚类别,以及亲子沟通对同伴侵害亚类别的预测作用。结果发现:(1)流动儿童同伴侵害存在4个亚类别,分别为“高侵害组”(3.89%)、“中侵害组”(11.13%)、“中侵害-低关系侵害组”(26.84%)和“低侵害组”(58.14%),处于不同亚类别的流动儿童在内、外化问题上存在显著差异;(2)亲子沟通水平越高,流动儿童越不可能处在频率更高、形式更多的同伴侵害亚类别中。研究表明,流动儿童同伴侵害具有异质性,亲子沟通是同伴侵害亚类别的重要保护因素。以上发现对流动儿童同伴侵害的预防干预实践具有一定的指导意义。

不同城乡及地区学龄前儿童水摄入量研究

目的:分析我国不同城乡及地区3~6岁学龄前儿童水摄入量。方法:采用多阶段随机抽样,于2018年9月—2019年2月在全国范围6大地区13省市的妇幼保健院纳入676名儿童。采用面对面访谈,调查员指导看护人利用iPad填写膳食日记,辅以膳食估量工具“食物图谱”在线记录并评估儿童4d内所有饮料和食物摄入量。基于《中国食物成分表(第6版)》计算每日水摄入量。结果:城市儿童总水摄入量、饮料和食物中水摄入量均显著高于农村(1282 mL/d>1118 mL/d,694 mL/d>613 mL/d,557 mL/d>467 mL/d)(P<0.05)。华北总水摄入量、饮料和食物中水摄入量均最高,东北均最低,地区间差异均有统计学意义(P<0.05)。城市奶及奶制品、菜肴、汤和零食中水摄入量及占比均显著高于农村,白水和主食占比、粥中水摄入量及其占比则相反,城乡差异均有统计学意义(P<0.05)。除其他饮料占比外,地区间不同类型饮料和食物中水摄入量及占比差异均有统计学意义(P<0.05)。仅19.4%儿童达到总水适宜摄入量的推荐值,城市高于农村(23.5%>13.1%);华北最高(45.3%),东北最低(2.2%),城乡及地区间差异均有统计学意义(P<0.05)。结论:我国学龄前儿童饮水状况差,存在城乡及地区差异,修订水适宜摄入量时需综合考虑,并开展针对性儿童饮水宣教,培养正确的饮水行为。

家庭子女结构对劳动者多重就业行为的影响研究

本研究聚集于多重就业现象,即个人同时从事多份工作。尽管已有大量研究考察生育对劳动力市场参与的影响,但生育对劳动者多重就业影响的研究相对较少。本研究利用2018年中国劳动力动态调查数据,探讨了家庭子女结构对父母多重就业的影响,主要涉及子女数量和性别。结果显示,子女数量与多重就业行为显著相关,二孩家庭的多重就业概率显著高于一孩家庭,但在三孩及以上时影响减弱。农业户口和男性劳动者在子女数量增加时更倾向于多重就业,而女性未表现出显著影响。此外,有儿子的家庭更倾向于多重就业,尤其是在农业户口家庭中,这可能与儿子对家庭财富积累产生的经济压力有关。本研究为理解家庭结构与劳动力市场参与的关系提供了新视角。

城市地区学前儿童家庭教育的社区支持现状与影响因素研究——以武汉市为例

社区的合理支持对提高学前儿童家庭的家庭教育质量具有重要意义。本研究选取武汉市0~6岁儿童家长与一线社区工作者为研究对象,通过问卷与访谈了解当今城市地区学前儿童家庭教育社区支持的现状与影响因素,并针对此提出可行的优化建议。本研究发现,当前社区在支持学前儿童家庭教育方面存在硬件设施支持较好,但教育学习指导不足的问题。受不同因素的影响,社区提供的支持服务质量与学前儿童家长接受的支持服务质量存在差异,主要表现为中心城区社区或新型社区能在特定领域提供更高质量的支持服务、大龄幼儿家庭或高SES家庭能在多个领域获得更高质量的支持服务,以及季节性疾病流行期间社区支持服务的质量有所不同等。针对以上现象,本研究从多方力量相助、社区资源共享与线上资源开发三个角度提出了改进建议。